• CCTV, staffing and physical restraints highlighted at UHW unit
Eoghan Dalton Reports
The admission of children into the adult mental health unit at University Hospital Waterford is “totally unacceptable”, according to the Mental Health Commission. Eight children were admitted to the Department of Psychiatry at UHW since last July, despite it lacking age-appropriate facilitiesThe Commission published its inspection reports in three approved centres this week, in Waterford, Clare and Cork which identified twelve areas of high risk non-compliance in the centres.
“Admitting any child to an adult service should only occur in exceptional circumstances,” commented Dr Susan Finnerty, Inspector of Mental Health Services.
The Commission said that not all staff involved in the care of children had the necessary training. The report stated: “Age-appropriate facilities and a programme of activities were not available. Child residents did not have access to age-appropriate advocacy services.”
The approved centre, which has 44 beds in two areas, an acute unit ward with 14 beds, and a sub-acute unit, Comeragh ward, with 30 beds, also struggles to achieve compliance with regulations, said the report.
There were 43 residents at the time of the inspection.In 2019 compliance decreased to a “low level” of 57 per cent. Compliance in 2017 was 64 per cent and 68 per cent compliance in 2018. The Commission further said that seven areas of non-compliance in its inspection have remained non-compliant for the past three years. One area of compliance had a quality rating of excellent on this inspection.
There were high risk problems surrounding several areas including use of physical restraint, use of CCTV, staffing and register of residents.Residents’ general health needs were not monitored and assessed by their specific needs. Physical examinations were inadequate, and did not consistently include an assessment of residents’ body mass index, weight, waist circumference, blood pressure, smoking status, and dental health.Residents did not have access to a supply of appropriate emergency personal clothing and there was only old clothing which was “stored in a disorganised manner and it was unclear what was available concerning size and gender-specific clothing”.
No emergency underwear was available to residents either, said the report.
Regarding staffing, the unit did not ensure that two staff were in attendance at all times when searches were being conducted and at least one staff member was not the same gender as one resident who had been searched. A written record of all environmental searches was also not kept.The centre was “not clean, hygienic, and free from offensive odours”, while two toilets were “malodourous”. On CCTV, the Commission said: “Monitors were not viewed solely by the health professional responsible for the health and safety of the resident.
“Monitors in both nurses’ stations could be viewed by the public from the corridors through glass panels and anyone passing the nurses’ office could see the monitor and CCTV images.”
There were two conditions attached to the registration for premises and staffing and the approved centre was not in breach of either condition.These covered a requirement that the centre undertake essential maintenance and refurbishments of the 14-bed unit to ensure there are appropriate communal spaces for therapeutic services, recreational activities, dining, and to facilitate visitors. These works had to be completed by before 2018.
The other condition centred around a requirement that all healthcare professionals working in the approved centre are up to date in mandatory training areas